developing & searching a population health question

DEVELOPING & SEARCHING A POPULATION HEALTH QUESTION

Mercer University School of Medicine Libraries

FORMULATING A POPULATION HEALTH QUERY

Identify a health concern Example: you are working in the East

Georgia Healthcare Center in Swainsboro and notice that a lot of your patients have diabetes.

WHAT CAUSES DISEASE? Why are there so many people in

Emanuel County with diabetes?

WHAT CAUSES DISEASE? How you conceptualize your topic

affects how you search for relevant information.

Consider the interaction and interdependenceof various factors

WHAT CAUSES DISEASE? Think about the

wider context of your topic.

Do some preliminary exploration.

PRELIMINARY EXPLORATION What percentage of the United States

population is diagnosed with diabetes? You will need to look for statistics.

PRELIMINARY EXPLORATION To find health

statistics, go to the libraries page at http://med.mercer.edu/library and choose Health Statistics & Research from the pulldown menu.

Click on CDC: Diseases and Conditions

8.4% OF ADULTS IN THE U.S AND 10% IN GEORGIA WERE DIAGNOSED WITH DIABETES IN 2009

PRELIMINARY EXPLORATION What percentage of people in Emanuel

County have diabetes? http://www.cdc.gov/diabetes/atlas/coun

tydata/atlas.html Centers for Disease Control &

Prevention, Diabetes Public Health Resources, Diabetes Interactive Atlas, 2009 data

11.2% OF ADULTS IN EMANUEL COUNTY WERE DIAGNOSED WITH DIABETES IN 2009

IS YOUR TOPIC RESEARCHABLE? Why do more adults in Emanuel County

have diabetes than the national average?

If your topic is too narrow, it may prove difficult to find research

If your topic is too broad, it may be impossible to cope with the vast amount of literature on an unfocused topic

FOCUS YOUR RESEARCH WITH A PICO QUESTION.

What does PICO stand for? P stands for Population or Patient I stands for Intervention C stands for Comparison O stands for Outcome

FOCUS YOUR RESEARCH WITH A PICO QUESTION.

What Population do you want to research?

In this case, it is adults with diabetes.

FOCUS YOUR RESEARCH WITH A PICO QUESTION.

What would be an Intervention? In this case, think about what might

contribute to diabetes.

FOCUS YOUR RESEARCH WITH A PICO QUESTION.

Sometimes a Point-of-Care database with distilled information will help you focus.

Go to the Dynamed Database (found in the pulldown menu on the library page http://med.mercer.edu/library)

EXPLORE A CONCEPT What percentage of adults in the

United States Smoke? http://apps.nccd.cdc.gov/statesystem/I

nteractiveReport/InteractiveReports.aspx

Centers for Disease Control, Smoking and Tobacco Use, Interactive Maps, 2010

19% OF ADULTS IN THE U.S & 17.6% IN GEORGIA, 2010

EXPLORE A CONCEPT What is the percentage of adults in

Emanuel County smoke? http://www.countyhealthrankings.org/a

pp/#/georgia/2013/measure/factors/9/map

County Health Rankings and Roadmaps, 2013

PRELIMINARY EXPLORATION To find health

statistics, go to the libraries page at http://med.mercer.edu/library and choose Health Statistics & Research from the pulldown menu.

Click on CDC: Diseases and Conditions

23% OF ADULTS IN EMANUEL COUNTY SMOKE

FOCUS YOUR RESEARCH WITH A PICO QUESTION.

What is your Intervention? In this case it would be smoking

cessation Is there a comparison? You don’t have

to have one. What is the Outcome you want? In this case it would be improved health

FOCUS YOUR RESEARCH WITH A PICO QUESTION.

Your PICO question would be In adults with Diabetes Mellitus, does

smoking cessation result in improved health?

SEARCHING THE LITERATURE Go to the library webpage at http://med.mercer.edu/library and

select PubMed from the pulldown menu.

SEARCHING THE LITERATURE You can type in keywords

SEARCHING THE LITERATURE If you want to narrow results, select MESH Databases

SEARCHING THE LITERATURE Type “Smoking Cessation”, select it, and add it to the

search builder

SEARCHING THE LITERATURE Type “diabetes,” select Diabetes Mellitus, and add it

to the search builder

SEARCHING THE LITERATURE Click Search PubMed

SEARCHING THE LITERATURE View your results

SEARCHING THE LITERATURE

To narrow further, you can can filter your results

SEARCHING THE LITERATURE In this case limited to Randomized Controlled Trials

SEARCHING THE LITERATURE Click on the “Get It @ MUSM Medical Libraries”

button to see if the libraries have a subscription/access so that full text is free to you.

SEARCHING THE LITERATURE If we don’t have a

subscription, we can order the article for you from another library via InterLibrary Loan.

Go to the libraries webpage at http://med.mercer.edu/library and look for InterLibrary Loan under Services.

It might arrive the same day, or it might take several days, depending on the library that owns it.

SEARCHING THE LITERATURE What do you do if you have too many

results? Think about your PICO. Do you need to

refine and narrow your research? What if you have too few results? Think about your PICO. Do you need to

refine and broaden your research?

SEARCHING THE LITERATURE If you are not getting many results,

maybe you need to look in another database.

Try Google Scholar Go to the library webpage at

http://med.mercer.edu/library and select Google Scholar from the pulldown menu.

SEARCHING THE LITERATURE You can refine your results by using the Advanced

Search

SEARCHING THE LITERATURE You can look for all of the words, the exact phrase, a

least one of the words, without the words, anywhere in the article, in the title of the article, by a specific author, or in a specific journal or a specific date.

SEARCHING THE LITERATURE You can sort by relevance or by date. Click on “Get

it @ MUSM Libraries” to see if the libraries have a subscription/access so that full text is free to you.

EXAMPLE POPULATION HEALTH QUESTIONS Does involving the male partners of pregnant teens increase the uptake of

prenatal care?

Does eliminating vending machines in middle schools result in decreased student obesity in those schools?

In a workplace with a mostly sedentary environment, do workplace ergonomic interventions result in increased workforce productivity?

In women with HIV, do peer-based interventions reduce health inequities?

In children and youth aged 5 to 17 years, what is the effect of regular and frequent physical activity at school on measures of learning performance or absenteeism?

Are adults or children exposed to poor air quality at increased risk for impaired cognitive performance?

FOR ASSISTANCE Macon: reference.ill@gain.mercer.edu 478.301.4056 Savannah: library@memorialhealth.com 912.350.8345